FARRELL J.LLOYDMD, MPH
CURRENT TREATMENT paradigms for type 2 diabetes mellitus usually relegate insulin to the position of a last option, for patients in whom monotherapy or combination therapy with oral agents has failed. When insulin is used in this scheme, the common practice is to add it to the oral agent regimen rather than use it by itself. However, this treatment approach does not recognize the natural course of type 2 diabetes and the importance of tight glycemic control. Very often, less than optimal glycemic control is the consequence of maintaining oral agents in the management of type 2 diabetes.
Westphal SA, Palumbo PJ. Insulin and Oral Hypoglycemic Agents Should Not Be Used in Combination in the Treatment of Type 2 Diabetes. Arch Intern Med. 2003;163(15):1783–1785. doi:10.1001/archinte.163.15.1783